Letter to Dr Norman Swan, Radio National Health Report Presenter

‘What the healthcare industry can learn from aviation’ I came across your episode of The Health Report through Twitter. http://www.abc.net.au/radionational/programs/healthreport/what-the-healthcare-industry-can-learn-from-aviation/10265132 I was moved to respond to the Health Report website with the following letter: Dear Dr Swan, Dr Paul Barach and Mr Richard de Crespigny Please accept my gratitude for your ongoing work. I would like to draw your attention to the following initiative and would value your thoughts. ‘Below Ten Thousand’ was created following a conversation between two clinical nurses in the operating theatres at University Hospital Geelong. The discussion centred around noise and distraction present in the operating room at the key times of induction of anaesthesia and extubation. The solution arrived at by John Gibbs, a clinical nurse specialist, was that any team member, on finding that noise and distraction was impinging on their cognitive or communication performance could invoke a safety environment using the trigger phrase ‘Below Ten Thousand’. The phrase ‘Below Ten Thousand’ is a reference taken from the aeronautical ‘Sterile Cockpit’ rule which seeks to attain a distraction free focus environment at any time required, but specifically when a plane is between the ground and ten thousand feet. The trigger phrase is designed to be unique, harm free and conflict avoidant, and is simply called to the room to evoke situational awareness and focus on the task at hand. Operating theatres are complex, busy and noisy environments as teams within teams work together to attain patient safety and wellbeing, often in extremely high pressure circumstances. Rob Tomlinson, a nurse at East Lancashire Hospital Trust, has used the initiative to prevent Never Events at his hospital, and through doing so has won on 26/09/18 a national Patient Safety Learning Award for his efforts in the NHS. ‘Below Ten Thousand’ is free, freely available and freely supported, and our international collaboration with Rob among others, is seeing progress in the creation of a safety culture which addresses what was previously widely acknowledged in operating theatres globally but which seemed at the time an unsolvable patient safety dilemma. For more information see our website www.belowtenthousand.com Kind regards, Pete Smith Grafton NSW 0404014338

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